血肿微创穿刺术在急性硬膜下血肿并脑疝患者急救中的应用  

Application of microinvasive craniopuncture technique in treating cases with acute subdural hematoma and brain herniation

作　　者：宋保新[1] 欧洋[1] 李长宝[1] 王长成[1] 王岩[1] 

机构地区：[1]北京市平谷区医院,北京101200

出　　处：《基层医学论坛》2014年第7期832-833,共2页The Medical Forum

摘　　要：目的：探讨早期血肿微创穿刺术在急性硬膜下血肿合并脑疝患者急救中的作用。方法回顾性分析2005年1月-2012年12月我院手术治疗236例急性硬膜下血肿合并脑疝患者的临床资料，根据是否进行早期血肿微创穿刺分为2组，微创穿刺组（术前利用YL-1型颅脑穿刺针行血肿微创穿刺）130例；非穿刺组106例。结果随访6个月~1年，微创穿刺组格拉斯哥预后评分（GOS）4~5分35例（26.9%），2~3分32例（24.6%），1分63例（48.5%）；非穿刺组GOS 4~5分16例（15.1%），2~3分25例（23.6%），1分65例（61.3%）。微创穿刺组预后良好/中残（GOS 4~5分）情况明显优于非穿刺组（P〈0.05），病死率（GOS 1分）明显下降（P〈0.05）。结论早期血肿微创穿刺排血能够改善急性硬膜下血肿合并脑疝患者的预后，提高治疗效果。Objective Aim to evaluate the effect of microinvasive craniopuncture technique on patients with subdural hematoma and brain herniation. Methods Data of 236 cases with subdural hematoma and brain herniation between 2005.1 and 2012.12 were collected. Prompt drainage of subdural hematoma through microinvasive craniopuncture with YL-1 puncture needle was applied in 130 cases as first aid before craniotomy, in comparision with the left 106 cases. Glasgow Outcome Scale （GOS） was used to assess the result. Results the patients were followed up between 6 months and one year. GOS scores were as follows：4~5 scores in 35 patients, 2~3 scores in 32 patients and 1 score in 63 patients in the microinvasive craniopuncture group, while 4~5 scores in 16 patients, 2~3 scores in 25 patients and 1 score in 65 patients in the control group （P＆lt;0.05）. Conclusion Prompt drainage of subdural hematoma through microinvasive craniopuncture with YL-1 puncture needle as first aid improves the therapeutic effect in treating cases with subdural hematoma and brain herniation.

关 键 词：急性硬膜下血肿 脑疝 YL-1型颅脑穿刺针 微创穿刺 

分 类 号：R651.15[医药卫生—外科学]